THE HIP
| The hip joint is a ball and socket joint, similar to the shoulder joint. Important parts of the hip joint are the femoral head (ball) and the acetabulum (socket). Both of these are lined with smooth cartilage that allows for friction-free movement when walking. The acetabulum is also rimmed with a labrum to help deepen the socket. Other important anatomy in the area is the greater trochanter and the trochanteric bursa. This bursa helps the bony prominence of the greater trochanter glide without insult to the thigh soft tissue with leg movement. | |
TROCHANTERIC BURSITIS
The trochanteric bursa is a structure that allows for smooth painless gliding of the lateral bony prominence of the hip (greater trochanter) against the skin and thigh soft tissues. This bursa can become inflamed and irritated and become extremely painful. Patients with trochanteric bursitis describe burning pain on the outside of their hips, pain with walking, and pain with laying on that side.
Trochanteric bursitis can be treating initially with physical therapy and anti-inflammatory medications. If this is not successful, then a cortisone injection usually is successful in treating this condition. On rare occasions, surgery and removal of this bursa is needed to treat trochanteric bursitis.
HIP JOINT OSTEOARTHRITIS
Osteoarthritis of the hip is defined as loss of the smooth cartilage that lines the joint surfaces of the hip on both the ball and the socket. This usually occurs from gradual wear and tear and can be accelerated by previous trauma, obesity, or congenital hip deformity. Patients with hip arthritis describe deep seated pain in the groin, decreased hip range of motion, pain with walking, decrease in walking endurance, and difficulty performing daily household tasks.
Hip arthritis can be initially treated with physical therapy and anti-inflammatory medications. If this does not help, cortisone injections or viscosupplementation injections can be administered. The definitive treatment for hip arthritis is hip replacement, known as hip arthroplasty. This is a surgical procedure that replaces the damaged lining of the ball and socket with metal, plastic, or ceramic lining, eliminating the pain of arthritis.
Hip Impingement/Labrum Tear
Hip impingement is a condition in which there is pain around the hip from anatomic pinching of the hip joint. This can occur from bony overgrowth an either the femoral (ball) side or acetabular (socket) side of the hip joint. This often results in tearing of a cartilage structure in between call the labrum, which also results in hip pain. Impingement can be treated with physical therapy, hip injections, and hip arthroscopic surgery.